EVENTS

Reflections on the health care ruling and the reactions

I was occupied for most of yesterday and did not have time to follow the reactions to the news that almost every aspect of the Affordable Care Act (ACA) had been upheld by the US Supreme Court. When late at night I did catch up on the coverage, there seemed to be basically four groups of stories.

One was the predictable and favorite one of speculating about the impact this will have on the November elections. Every single issue from now until November will suffer this same fate because it enables pundits to indulge in content-free talk, their favorite kind. .

The second was also predictable, trying to understand how it came to be that it was Chief Justice John Roberts who ended up siding with the so-called liberal wing to give the 5-4 margin. Trying to infer Supreme Court internal dynamics and motives has replaced the Kreminology that flourished during the Cold War, and also provides endless opportunities for mindless chatter.

The third was the freak out by those in the Tea Party and its allies who have built up in their minds the idea that the ACA marked the end of civilization as we know it and predicted that this ruling signaled the death knell of America. See here for some examples of the more extreme reactions. This was also drearily predictable, if amusing.

The thing that did surprise me was the surprising amount of attention paid to the fact that CNN and Fox News had initially mistakenly reported that the individual mandate, the centerpiece of the law, had been overturned and had to correct it a few minutes later. To me this was not news, though it did highlight the absurdity of the obsession by news organizations to be first, even by a few minutes or even seconds, even if the news itself has no urgency. People in the news business don’t seem to grasp that unless people’s lives depend on it, the speed of reporting the news is of little import.

In their desire to be the first, even by an insignificant amount of time, the news organizations did not wait to read the ruling or even wait until the Chief Justice had finished speaking. Instead, news producers inside the courthouse relayed bits and pieces as they heard them to reporters outside who then broadcast the news. When the Chief Justice said that the individual mandate could not be justified under the constitution’s commerce clause, they immediately jumped to the conclusion that it had been overturned, before later hearing that the mandate could be justified under the government’s taxing powers. The only lesson that should be gleaned from this minor idiocy is that being first by a few minutes does not matter. But I doubt they’ll learn it.

The Daily Show had a good segment ridiculing this absurd media obsession with trying to be first, and their attempts to anticipate what the ruling would be when absolutely no purpose would be served by such speculations.

(This clip appeared on June 27, 2012. To get suggestions on how to view clips of The Daily Show and The Colbert Report outside the US, please see this earlier post.)

As for the health care act itself, I was very critical of it when it was passed. I am a supporter of a publicly funded single-payer system because it is crazy to have a private employer-based health care system. I have explained my reasons and the specific forms that I feel such a system should take in a series of posts on health care and will point to specific ones for those interested in the details.

I feel strongly that the private health insurance industry is a parasitic institution that not only does not provide any benefits to anyone, it instead drains huge amounts of resources from health care in the form of profits to shareholders, high salaries to executives, high overhead costs, and bureaucratic inefficiencies. Add to that the enormous aggravation of all the many rules and hoops that one has to jump through to get coverage and it is no surprise that people in other countries are incredulous that we have tolerated this terrible system for so long. I felt that the ACA would force more people into purchasing insurance from the same greedy and parasitic institutions that are a major part of the problem.

But despite these serious misgivings, I wanted the ACA to be upheld, because I did not want the perfect to be the enemy of the good (as Voltaire said) so I was glad that this ruling came down. The idea of more people having access to health care (though over 23 million still won’t be covered), the elimination of denial for pre-existing conditions, allowing young people under 26 to stay on their parents’ insurance plans, the expansion of Medicaid coverage to more people, and the introduction of health exchanges to make it easier to find affordable health insurance for those who do not have employer-based coverage, are all good things.

Instituting a universal publicly funded single-payer system would not be hard since we already have in place such a system that runs pretty smoothly, though it serves a limited population of just those over 65. That is Medicare. While it has problems and can and should be improved, it already exists and provides health coverage at much lower administrative cost than the private systems, and with none of the aggravation. What I would like to see is what that excellent organization Physicians for a National Health Program (PNHP) calls ‘Improved Medicare For All’. (See their 2010 statement on the original legislation.) The expansion of more people into Medicare could be gradual so as not to cause too much disruption, starting first with all children and young adults (say all those under 25), and then steadily adding age cohorts from both ends of the age spectrum 25 to 65.

The ACA is just a small step forward but has so many problems that will become apparent down the road that it may trigger greater support for a truly universal publicly funded single-payer system.

Not that is was Fox News’ intent this time, but they DO have a history of trying to drive societal memes in their favor by saying it early, often and loudly. A prime example of this is the 2000 presidential election. Fox News called Florida for Bush relatively early. The other networks and CNN, did not until much later, days in some cases. During the recount, republican staffers mobbed the clerk’s offices across the states, to mimic a grass-roots uprising. It had the appearance of Fox peddling the meme that this was a fait accompli.